Kidney rules `restrictive'

WIDER POOL Allowing families of kidney-failure patients to exchange organs may increase the number of transplants and reduce waiting time, doctors say

By Wang Hsiao-wen / STAFF REPORTER

In hopes of shortening the amount of time sick people have to wait for a kidney transplant, physicians yesterday called on the government to consider loosening its regulations and allow kidney exchanges among patients and families.

The kidney shortage has long troubled people suffering from kidney failures. Every year in this country, 40,000 people have to undergo dialysis three times a week to ease uremia, and only about 100 kidneys are available in a year, according to the National Kidney Foundation.

The waiting list for a new kidney grows longer ever year.

A survey conducted by Huang Chiu-jing (黃秋錦) at the Chung Kung Memorial Hospital indicated that a person on the waiting list has to wait on average four years before having a kidney transplant.

"We all know that a kidney transplant is better for patients and doctors can do it. It is the scarcity of kidneys that bothers patients and doctors," Huang said.

Clinical research has proven that a kidney transplant is the best way to treat uremia and other chronic kidney failures, doctors said. "As medical technology has made great strides in recent years, a kidney transplant is no longer a risky procedure," said Yang Wu-chang (楊五常), the chief the Taipei Veterans General Hospital renal department.

"The survival rate for patients with kidney transplants is now higher than for those who have dialysis. Those who have successful kidney transplants before the age of 65 are even less vulnerable to cardiovascular diseases," Yang said.

However, the strict regulations of the Organ Transplant Law (人體器官移植條例) often reduce prospects of receiving a healthy kidney.

The law stipulates that only families within five branches of a patient's genealogical tree can donate their organs. According to Yang, this regulation narrows the scope of organ availability and dash many people's hopes.

"It is hard to match the tissue and blood types when we only have a small pool of potential donors," Yang said.

"There are too many cases where families want to donate their kidneys but the physiology made it impossible."

According to Yang, if the government can lessen its control over organ donations and allow families of patients to exchange kidneys, the likelihood of getting a kidney will sharply increase.

Increasing the number of transplant operations could ease the financial burden on the Bureau of National Health Insurance. The bureau spends between NT$20 billion and NT$30 billion on dialysis a year. While dialysis for a single patient costs the bureau about NT$620,000 a year, a kidney transplant costs the bureau NT$220,000 per person in reimbursement payments to hospitals and doctors.

Yet the exchange of organs isn't just an issue about helping patients or reducing economic costs, heath officials contend. The final hurdle is ethical concerns.

"In the case of organ donation, we have to protect not only the recipient but also the donors. We have to make sure donors are not being exploited," said Hsueh Jui-yuan (薛瑞元), director-general of the Bureau of Medical Affairs.

According to Hsueh, it is equally important to preclude the possibility of organ trades and to ensure that a donor make his or her own decision without economic or family pressure.